Mental Health in the Aftermath of Conflict

by Quy-Toan Do & Lakshmi Iyer

Executive Summary — Wars are detrimental to the populations and the economy of affected countries. Over and above the human cost caused by deaths and suffering during a time of conflict, survivors of conflict are often left in poor economic circumstances and mental-health distress even after the conflict ends. How large are these costs? How long does it take for conflict-affected populations to recover from the mental stress of conflict? What policies are appropriate to assist mental health recovery? While considerable attention has been paid to post-war policies with regard to recovery in physical and human capital, mental health has received relatively less attention. The World Bank's Quy-Toan Do and HBS professor Lakshmi Iyer review the nascent literature on mental health in the aftermath of conflict, discuss the potential mechanisms through which conflict might affect mental health, and illustrate the findings from their study of mental health in a specific post-conflict setting: Bosnia and Herzegovina. Key concepts include:

Mental health is an outcome that deserves greater attention from scholars and policymakers alike.

Mental health is an important dimension of human capital. Mental health distress, while a matter of concern in and of itself, might also have adverse consequences for individuals' labor force participation and labor productivity in the post-conflict period, thereby delaying economic recovery after the conflict ends.

Quantifying the effect of conflict on mental health is likely to be important for designing appropriate post-conflict policies for recovery.

Somewhat surprisingly, findings showed no significant differences in overall mental health across people who experienced different levels of exposure to the conflict.

People with more education, as well as those who move to a different locality after the conflict, suffer fewer conflict-related mental health consequences.

Author Abstract

We survey the recent literature on the mental health effects of conflict. We highlight the methodological challenges faced in this literature, which include the lack of validated mental health scales in a survey context, the difficulties in measuring individual exposure to conflict, and the issues related to making causal inferences from observed correlations. We illustrate how some of these issues can be overcome in a study of mental health in post-conflict Bosnia and Herzegovina. Mental health is measured using a clinically validated scale; conflict exposure is proxied by administrative data on war casualties instead of being self-reported. We find that there are no significant differences in overall mental health across areas which are affected by ethnic conflict to a greater or lesser degree. 27 pages.